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Gastric bypass or sleeve?



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When I visited my surgeon, he said I am a great candidate for either surgery. He said my medical history doesn't sway things one way or the other. I don't have diabetes or any other comorbidities. Even after researching both to death, I can't seem to make my mind. I like that the bypass has been around longer and is well-studied. I like that the sleeve requires less realignment and seems to carry a little less risk. I've wondered if having the bypass and risk of dumping syndrome would help because I have a real sweet tooth. I understand both induce important hormonal changes, but I can't judge from the information I've gathered which set of hormonal changes will benefit me the most. Anyone else have this much trouble choosing? What factors swayed you one way or the other?

Edited by letitbeatles9

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I had the same conversation with myself. I was a good candidate for either, and also have a sweet tooth. RNY was the gold standard and more widely used, with lots of data to support it as resulting in the greatest weight loss of all types of WLS at the time I had my surgery. Statistically, I could lost and maintain about 10% more with RNY than a sleeve, which is a significant amount of weight when you are starting at over 300 pounds.

I ended up going with the sleeve because I didn't want the risks associated with the malabsorption component of RNY (still have some risks with the sleeve, but less so) and I wanted to be able to take NSAIDS for arthritic pain. I also didn't want the risk of dumping.

I've been very happy with my choice. I've lost and maintained more than the statistical averages with either surgery, at over 90% lost. Sometimes I wonder if I would have lost the last few pounds with RNY, but it doesn't really matter because I'm a normal size woman with a nice, normal life now. :)

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I was like you no comorbities. I was a great sleeve candidate. I was a terribly slow loser which I learned to live with. I have since had some complications post pregnancy and will be revised to bypass soon. I have developed terrible GERD with my sleeve. Also, some sleeve drs still do not advise taking NSAIDS. I took them after my c-section and thought I was gonna have a heart attack. Since then my surgeon had told me to stop using them. I think this is an area that is still conflicting amongst the sleeve community. People have success with both and there can be complications with both.

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I chose the sleeve over other types of WLS simply because I didn't like the idea of them re-routing my intestines. Also I knew I wanted something permanent. I wasn't comfortable with the malabsorption that came with the bypass and I didn't choose the band because I didn't want the maintenance involved with getting fills. I was sleeved on 6-15. I have lost 30 pounds and I am very pleased.

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My surgeon said either would be fine for me, but I had GERD so I went with the bypass. GERD often (but not always) gets worse with the sleeve, but usually improves or goes away with the bypass. If it weren't for the GERD, it would have been a much tougher decision for me. I"m sure I would have been happy with either choice.

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The idea of touching my intestines is what has put me off weight loss surgery for years. The complications and the types of complications are just too risky. I would rather die fat than deal with intestinal issues.

The people that I have known that have RNY, they get hungry, really hungry about a year out. I think it is because their stomach is still there producing all those hormones and interacting with their brain.

In the end it is a personal choice, but I felt the sleeve gave me the best chance with the least amount of risk. I didn't like that RNY would make me too different for the rest of my life. Plenty of people have parts of their stomach removed for all kinds of reasons and live perfectly normal lives. Rerouting your intestines sets you up for issues for the rest of your life.

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Thank you everyone for your comments! It helps to hear different perspectives.

@@MichiganChic Congratulations on your success with the sleeve! I don't know if you felt this way in your pre-surgery days, but I feel like I'm addicted to sweets. Would you mind sharing how you got over your sweet tooth? Did the intense cravings ever come back? If they did, how did you deal? Do you ever eat sweets in moderation or have you just never picked it up again?

@ I'm planning on getting pregnant maybe two years or more out from my surgery. May I ask if your post-pregnancy complications were something common in sleeve patients? I'm wondering if there's something here I should consider?

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@ I'm planning on getting pregnant maybe two years or more out from my surgery. May I ask if your post-pregnancy complications were something common in sleeve patients? I'm wondering if there's something here I should consider? [/quote

I see many successful post pregnancy sleevers on here. My complication is NOT common. My sleeve is angulated (twisted) if you search that, you will find that is a late term side effect (not sure if it's pregnancy related). I also have a hiatal hernia, not pregnancy related. My sleeve is also distended. So the way he explained, my sleeve is not emptying food the way it should. I say all this, but also note I was a prime sleeve candidate.

I went through therapy, almost a year of nutritional counseling prior to deciding on the sleeve. I worked out pre/post sleeve. I don't think there is a way to know if you will have complications. I will also note, I was only 11 months post op when I got pregnant. I was 39 years old, so high risk and had only lost about 50% of excess weight.

I am excited about my bypass and new possibilities. Although, it is emotional going through this all over again and the fear of failing.

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@ Thank you for the info. Wishing you the best of luck with your bypass! I know that must be really tough, so I'm rooting for you!

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@ Thank you for the info. Wishing you the best of luck with your bypass! I know that must be really tough, so I'm rooting for you!

Thank you! I wish you the best either way you decide to go! At the end, you will be healthier, happier and slimmer! I would discuss your concerns with your surgical team. They are a great resource and can assist you in making the best decision for you and your situation.

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Thank you everyone for your comments! It helps to hear different perspectives.

@@MichiganChic Congratulations on your success with the sleeve! I don't know if you felt this way in your pre-surgery days, but I feel like I'm addicted to sweets. Would you mind sharing how you got over your sweet tooth? Did the intense cravings ever come back? If they did, how did you deal? Do you ever eat sweets in moderation or have you just never picked it up again?

Thank you. I also love, love, love sweets! Cake is my weakness. I seriously used to bake all the time. I used to call the period between Christmas and Easter "cake season" because I was tired of Christmas Cookies, and I would make 3 or 4 cakes a week!

To be truthful, I am not over my sweet tooth. That's not to say I indulge or give in very often. I do allow some occasional treats, though. So, I find that if I avoid bread, rice, and Pasta, and don't eat processed foods, I'm pretty good. If I really feel like I want something sweet, I have a cup of flavored coffee with a little flavored Creamer (and I count the calories for that). It really helps with the cravings. I find that if I have sweets in the house, I'm drawn to them. I've learned to make the decision once - at the grocery store. I simply don't bring that stuff in, so if it's not here, I do pretty good.

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